Module 8: Neurology

Sex and gender affect the incidence, prevalence and dynamics of the nervous system with its central, peripheral and/or autonomic part and its effector tissue - particularly muscle.
Differences between the sexes have been documented at every level of neuroscience, from single neurons in cell culture to systems level processes as measured by neuroimaging. Anatomically, there are differences in the density of neurons, size of regional brain areas, expression of cell receptors and neurotransmitter systems. Physiologically there are differences in cerebral blood flow and cortical activation patterns. Gender aspects have so far played a minimal role in both research and clinical practice in the neuropsychiatric field. The examples given in this module include e.g. inflammatory (multiple sclerosis) and degenerative (Alzheimer’s and Parkinson’s) neurological diseases as well as Epilepsy a functional state of increased vulnerability to seizures.
Stroke can be devastating for all individuals who are affected; however, on a societal level women bear a greater burden of stroke than do men, largely driven by their longer life expectancy and the higher risk of stroke with advancing age. Women not only have more overall stroke events, but those who survive have poorer prospects for recovery, with worse functional outcomes and lower quality of life than men. It is therefore crucial that strategies to prevent stroke and provide access to treatments are improved in women. Many strokes are thought to be preventable. An improved awareness of the risk factors that are more common in women — principally hypertension, atrial fibrillation, and prestroke disability — and better strategies to manage them are urgently needed.

Author: Dr.med. Ute Seeland
ExpertsPD Dr.med. Christian Nolte, Prof. Dr.med Karin Schenck-Gustafsson